pneumothorax

Overview

A pneumothorax, commonly known as a collapsed lung, occurs when air leaks into the pleural space—the area between the lung and the chest wall. This excess air puts pressure on the lung, causing it to partially or fully collapse. Pneumothorax can be a medical emergency, so prompt evaluation and treatment are crucial.

Types of pneumothorax

1. Primary Spontaneous Pneumothorax:
   • Occurs without an underlying health condition.
   • Often associated with the rupture of abnormal air pockets (blebs) in the lung.
2. Secondary Spontaneous Pneumothorax:
   • Linked to specific lung diseases (e.g., chronic obstructive pulmonary disease, cystic lung diseases).
   • May result from blocked airways and the subsequent rupture of bulging areas (bullae) in the lung.
3. Traumatic Pneumothorax:
   • Caused by injuries (e.g., fractured ribs, knife wounds) or medical procedures (iatrogenic).
4. Tension Pneumothorax:
   • A serious form where air enters the lungs but cannot escape, leading to increased pressure within the chest. Requires immediate medical attention.
5. Catamenial Pneumothorax:
   • Rare and associated with endometriosis. Endometrial tissue outside the uterus can bleed into the pleural space, causing lung collapse.

Causes of pneumothorax

• Chest Injury: Blunt or penetrating trauma to the chest (e.g., car accidents, physical assaults).
• Lung Diseases: Conditions like chronic obstructive pulmonary disease (COPD), emphysema, and pneumonia.
• Mechanical Ventilation: Ventilators can disrupt air pressure balance, leading to lung collapse.
• Ruptured Air Blisters (Blebs): Small air blisters on the lung’s surface may burst, allowing air to leak into the pleural space.

Risk Factors of pneumothorax

• Smoking: Increases the risk of pneumothorax.
• Lung Diseases: Pre-existing lung conditions elevate the likelihood.
• Hospitalization and Ventilation: Patients on ventilators are at higher risk.
• Family History: Certain cystic lung diseases have a genetic component.

Symptoms of pneumothorax

Preventions of pneumothorax

While prevention is challenging, quitting smoking reduces the risk of a first pneumothorax and recurrence.

Diagnosis of pneumothorax

• Lung Sonography: Provides a clear view of the lungs in emergency settings.
• Ultrasound: Detailed examination of thoracic structures.
• CT Scan: Detailed lung imaging.
• Chest X-ray: Diagnoses chest-related conditions.

Treatment for pneumothorax

1. Tube Thoracostomy (Intercostal Tube Drain):
   • Removes excess air by inserting a tube between the ribs.
2. Pleurodesis:
   • Injects chemical compounds to scar the pleural tissue, preventing recurrences.
3. Video-Assisted Thoracoscopic Surgery (VATS):
   • Identifies and closes leaking blebs using a small camera.

When to seek medical attention ?

Seek immediate medical attention if you experience symptoms of pneumothorax.